Onychomycosis is predominantly caused by the dermatophytes
Trichophyton rubrum,
Trichophyton mentagrophytes and
Trichophyton tonsurans. The main treatment obstacle concerns low nail-plate drug permeability.
In vitro antifungal photodynamic treatment (PDT) and nail penetration enhancing effectiveness have been proven for multifunctional photosensitizer 5,10,15-
tris
[...] Read more.
Onychomycosis is predominantly caused by the dermatophytes
Trichophyton rubrum,
Trichophyton mentagrophytes and
Trichophyton tonsurans. The main treatment obstacle concerns low nail-plate drug permeability.
In vitro antifungal photodynamic treatment (PDT) and nail penetration enhancing effectiveness have been proven for multifunctional photosensitizer 5,10,15-
tris(4-
N-methylpyridinium)-20-(4-(butyramido-methylcysteinyl)-hydroxyphenyl)-[21
H,23
H]-porphine trichloride (PORTHE). This study investigates single PORTHE green laser/LED PDT of varying degrees of
ex vivo onychomycoses in a human nail model.
T. mentagrophytes,
T. rubrum,
T. tonsurans onychomycoses were
ex vivo induced on nail pieces at 28 °C (normal air) and 37 °C (6.4% CO
2) during 3 to 35 days and PDTs applied to the 37 °C infections. All dermatophytes showed increasingly nail plate invasion at 37 °C between 7 and 35 days; arthroconidia were observed after 35 days for
T. mentagrophytes and
T. tonsurans. Using 81 J/cm
2 (532 nm) 7-day
T. mentagrophytes onychomycoses were cured (92%) with 80 µM PORTHE (pH 8) after 24 h propylene glycol (PG, 40%) pre-treatment and 35-day onychomycoses (52%–67%) with 24 h PORTHE (40–80 µM)/40% PG treatment (pH 5). 28 J/cm
2 LED light (525 ± 37 nm) improved cure rates to 72%, 83% and 73% for, respectively,
T. mentagrophytus,
T. rubrum and
T. tonsurans 35-day onychomycoses and to 100% after double PDT. Data indicate PDT relevance for onychomycosis.
Full article